| NPI | 1619352911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 72521) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 14589) |
| 183500000X Pharmacist (Licence: WA PH60643584) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: WA PH60643584) | |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2018-12-14 |